The separation-of-variable(SOV)methods,such as the improved SOV method,the variational SOV method,and the extended SOV method,have been proposed by the present authors and coworkers to obtain the closed-form analytica...The separation-of-variable(SOV)methods,such as the improved SOV method,the variational SOV method,and the extended SOV method,have been proposed by the present authors and coworkers to obtain the closed-form analytical solutions for free vibration and eigenbuckling of rectangular plates and circular cylindrical shells.By taking the free vibration of rectangular thin plates as an example,this work presents the theoretical framework of the SOV methods in an instructive way,and the bisection–based solution procedures for a group of nonlinear eigenvalue equations.Besides,the explicit equations of nodal lines of the SOV methods are presented,and the relations of nodal line patterns and frequency orders are investigated.It is concluded that the highly accurate SOV methods have the same accuracy for all frequencies,the mode shapes about repeated frequencies can also be precisely captured,and the SOV methods do not have the problem of missing roots as well.展开更多
Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsul...Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsulated by a fibrous wall, it is classified as a pancreatic pseudocyst. While PPC is generally asymptomatic in many patients, it can manifest with persistent abdominal pain, dyspepsia, intra-cystic infection, and potentially lead to gastrointestinal obstruction in some cases. Although smaller PPCs may resolve spontaneously, larger PPCs tend to be refractory to absorption and often necessitate surgical intervention to prevent complications such as intracystic hemorrhage. Objective: To explore the efficacy of percutaneous catheterization with negative pressure in the treatment of large pancreatic pseudocysts. Methods: The cases of large pancreatic pseudocysts treated in our hospital from 2004 to 2022 were retrospectively collected, and the general condition, operation time, drainage time, feeding time, postoperative complications, hospital stay, cost and follow-up of the patients were analyzed. Results: A total of 132 patients with large pancreatic pseudocysts were collected. The average operation time was 32.4 ± 2.1 min;The retention time of the drainage tube was 30 ± 1.8 days in the percutaneous negative pressure drainage group;The postoperative feeding time was no fasting after local anesthesia drainage;Postoperative complications (bleeding, infection, pancreatic leakage, recurrence, anastomotic leakage, etc.): Two of the 132 patients had recurrent cysts, which were cured by re-puncture and negative pressure drainage. The length of hospital stay was 6 ± 1.1 days;The cost was 11,200 ± 1300 yuan;Follow-up: The follow-up time ranged from 1 to 3 years, and the patients had no discomfort. Conclusion: Percutaneous catheterization and negative pressure drainage can effectively treat large pancreatic pseudocysts. Compared with other treatment methods, it is simple and effective, the postoperative recovery of patients is faster, the physical damage is less, the hospital stay is shorter, and the cost is lower.展开更多
Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,th...Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical approaches.Studies show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate expertise.For malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different modalities.The treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic therapy.Due to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging stents.These novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.展开更多
Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperativ...Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.展开更多
Understanding the wind power potential of a site is essential for designing an optimal wind power conditioning system. The Weibull distribution and wind speed extrapolation methods are powerful mathematical tools for ...Understanding the wind power potential of a site is essential for designing an optimal wind power conditioning system. The Weibull distribution and wind speed extrapolation methods are powerful mathematical tools for efficiently predicting the frequency distribution of wind speeds at a site. Hourly wind speed and direction data were collected from the National Aeronautics and Space Administration (NASA) website for the period 2013 to 2023. MATLAB software was used to calculate the distribution parameters using the graphical method and to plot the corresponding curves, while WRPLOTView software was used to construct the wind rose. The average wind speed obtained is 3.33 m/s and can reach up to 5.71 m/s at a height of 100 meters. The wind energy is estimated to be 1315.30 kWh/m2 at a height of 100 meters. The wind rose indicates the prevailing winds (ranging from 3.60 m/s to 5.70 m/s) in the northeast-east direction.展开更多
Modal parameters can accurately characterize the structural dynamic properties and assess the physical state of the structure.Therefore,it is particularly significant to identify the structural modal parameters accordi...Modal parameters can accurately characterize the structural dynamic properties and assess the physical state of the structure.Therefore,it is particularly significant to identify the structural modal parameters according to the monitoring data information in the structural health monitoring(SHM)system,so as to provide a scientific basis for structural damage identification and dynamic model modification.In view of this,this paper reviews methods for identifying structural modal parameters under environmental excitation and briefly describes how to identify structural damages based on the derived modal parameters.The paper primarily introduces data-driven modal parameter recognition methods(e.g.,time-domain,frequency-domain,and time-frequency-domain methods,etc.),briefly describes damage identification methods based on the variations of modal parameters(e.g.,natural frequency,modal shapes,and curvature modal shapes,etc.)and modal validation methods(e.g.,Stability Diagram and Modal Assurance Criterion,etc.).The current status of the application of artificial intelligence(AI)methods in the direction of modal parameter recognition and damage identification is further discussed.Based on the pre-vious analysis,the main development trends of structural modal parameter recognition and damage identification methods are given to provide scientific references for the optimized design and functional upgrading of SHM systems.展开更多
Objective Laparoscopic surgery has become a routine general surgery with many advantages,such as alleviating abdominal pain.However,postoperative pain caused by abdominal drainage tubes has attracted little attention ...Objective Laparoscopic surgery has become a routine general surgery with many advantages,such as alleviating abdominal pain.However,postoperative pain caused by abdominal drainage tubes has attracted little attention from medical staff.The aim of this study was to explore the influence of a new abdominal drainage tube fixation method for 3-port laparoscopic cholecystectomy(LC)on patients’postoperative quality of life.Methods Patients who underwent 3-port LC with abdominal drainage tubes in the Department of Hepatobiliary Surgery of Linyi People’s Hospital from March 1,2023 to October 31,2023 due to gallstones with chronic cholecystitis were selected for this study.The patients were randomly divided into an experimental group and a control group.In the experimental group,the new abdominal drainage tube fixation method was used,while in the control group,the traditional method was used.Afterward,the quality of life of patient in terms of pain,activity,recovery time,and mental health status was evaluated.The exudate around the patient’s drainage tube was collected for bacterial culture and analysis.Results A total of 139 patients were randomly divided into an experimental group(70 patients)and a control group(69 patients).The patients’baseline characteristics were not significantly different.The patients in the experimental group had better outcomes in quality of life,with higher pain scores(24.03±2.37 vs.15.48±2.29,p<0.001)and activity scores(20.57±1.78 vs.14.13±1.43,p<0.001),and a shorter postoperative recovery time(2.36±0.68 d vs.2.96±1.34 d,p<0.001).The same results were shown in linear regression analysis scores of the 2 groups.The positive rate of bacterial culture in the exudate around the patient’s drainage tube in the experimental group was significantly lower than that in the control group(12.9%vs.43.5%,p<0.001);and furthermore,the positive rate of conditional pathogenic bacteria was even lower(7.1%vs.33.3%,p<0.001)in the experimental group than in the control group.Conclusion This new abdominal drainage tube fixation method can effectively promote patient rehabilitation and improve the quality of life for patient following 3-port LC with abdominal drainage tubes.展开更多
Drainage divide migration refers to the shifting boundaries between adjacent drainage basins over time,driven by processes such as tectonic uplift,differential erosion,stream capture,and lithological variations.This p...Drainage divide migration refers to the shifting boundaries between adjacent drainage basins over time,driven by processes such as tectonic uplift,differential erosion,stream capture,and lithological variations.This phenomenon has a significant impact on water flow patterns and basin extents,serving as an indicator of the landscape's response to active tectonic forces.One of the key drivers of divide migration is asymmetric uplift,which causes divides to shift from areas of lower uplift to regions experiencing higher uplift.Drainage divides are inherently dynamic,evolving over time as drainage networks develop and adjust to changing conditions.This study focuses on the migration of the main drainage divide along Karιncalιda?,located between Bozdo?an and Karacasu.It employs geomorphic analyses using metrics such as the normalized steepness index(ksn),Chi(χ),and Gilbert metrics.The main divide is categorized into four segments(D1–D4),with the Karacasu Fault,situated along the mountain's north-eastern boundary,identified as the primary factor influencing divide dynamics.Secondary factors include the relatively low elevation of Karιncalιda?,uniform lithology,and consistent rainfall patterns across the region.The results indicate that the main divide is currently stable,suggesting a balance between uplift and erosion.However,higherχvalues in the D4 segment suggest that future erosion may dominate,potentially causing the divide to migrate toward the Bozdo?an Basin.These findings highlight the dynamic nature of drainage divides and the complex interplay of tectonic,erosional,and lithological processes that shape their evolution.Continued monitoring and advanced geomorphic analysis are essential for understanding the long-term stability of the divide and its response to future tectonic activity and erosional modifications.展开更多
Accurate acquisition and prediction of acoustic parameters of seabed sediments are crucial in marine sound propagation research.While the relationship between sound velocity and physical properties of sediment has bee...Accurate acquisition and prediction of acoustic parameters of seabed sediments are crucial in marine sound propagation research.While the relationship between sound velocity and physical properties of sediment has been extensively studied,there is still no consensus on the correlation between acoustic attenuation coefficient and sediment physical properties.Predicting the acoustic attenuation coefficient remains a challenging issue in sedimentary acoustic research.In this study,we propose a prediction method for the acoustic attenuation coefficient using machine learning algorithms,specifically the random forest(RF),support vector machine(SVR),and convolutional neural network(CNN)algorithms.We utilized the acoustic attenuation coefficient and sediment particle size data from 52 stations as training parameters,with the particle size parameters as the input feature matrix,and measured acoustic attenuation as the training label to validate the attenuation prediction model.Our results indicate that the error of the attenuation prediction model is small.Among the three models,the RF model exhibited the lowest prediction error,with a mean squared error of 0.8232,mean absolute error of 0.6613,and root mean squared error of 0.9073.Additionally,when we applied the models to predict the data collected at different times in the same region,we found that the models developed in this study also demonstrated a certain level of reliability in real prediction scenarios.Our approach demonstrates that constructing a sediment acoustic characteristics model based on machine learning is feasible to a certain extent and offers a novel perspective for studying sediment acoustic properties.展开更多
BACKGROUND Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed.It is often the result of chronic peptic ulcer disease,which is characterized...BACKGROUND Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed.It is often the result of chronic peptic ulcer disease,which is characterized by a breach in the gastric wall due to ulceration.Surgical intervention is essential for managing this life-threatening complication.However,the optimal surgical technique remains debatable among clinicians.Various methods have been employed,including simple closure,omental patch repair,and partial gastrectomy,each with distinct advantages and disadvantages.Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making.This study addresses the need for a comprehensive analysis in this area.AIM To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.METHODS A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023.The patients were divided into three groups based on the surgical method:Simple closure,omental patch repair,and partial gastrectomy.The primary outcomes were the operative success rate and incidence of postoperative complications.Secondary outcomes included the length of hospital stay,recovery time,and long-term quality of life.RESULTS The operative success rates for simple closure,omental patch repair,and partial gastrectomy were 92.5%,95%,and 97.5%,respectively.Postoperative complications occurred in 20%,15%,and 17.5%of patients in each group,respectively.The partial gastrectomy group showed a significantly longer operative time(P<0.001)but the lowest rate of ulcer recurrence(2.5%,P<0.05).The omental patch repair group demonstrated the shortest hospital stay(mean 7.2 days,P<0.05)and fastest recovery time.CONCLUSION While all three surgical methods showed high success rates,omental patch repair demonstrated the best overall outcomes,with a balance of high efficacy,low complication rates,and shorter recovery time.However,the choice of the surgical method should be tailored to individual patient factors and the surgeon’s expertise.展开更多
Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to ...Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to four groups:normal,sham operation,model,and TMTP Tuina.Successful model induction was confirmed by observable hind limb lameness.After 20 sessions,hind limb grip strength and motor nerve conduction velocity(MNCV)were measured at baseline and following the 10th and 20th intervention.CD31 and a-SMA in the ventral horn of SNI model rats were detected using immunofluorescence.Motor neurons in the ventral horn were detected by Nissl staining.PTEN levels in the ventral horn were measured by ELISA,and PI3K,Akt,BDNF,VEGF,and HIF-1a expression was determined by RT-PCR.Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt,p-Akt,BDNF,and VEGF.Results:Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group(both P<.001).Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group,with increased expressions of a-SMA(P=.002)and CD31(P=.006).Western blot analysis indicated increased expression of VEGF(P=.005),p-Akt(P<.001),and BDNF(P=.008)in the ventral horn following Tuina treatment.RT-PCR analysis revealed increased expression of PI3K,Akt,BDNF,VEGF and HIF-1a(all P<.05).In contrast,expression of PTEN decreased compared to the model group(P<.001).Conclusion:TMTP Tuina therapy may restore motor function in rats,enhance ventral horn motor neuron morphology,and promote angiogenesis and vascular smooth muscle proliferation.The mechanism may involve the activation of the PI3K/Akt signaling pathway.展开更多
With the acceleration of urbanization,the demand for water supply and drainage pipe networks has increased significantly.In the planning of urban construction,it is necessary to optimize the design of the water supply...With the acceleration of urbanization,the demand for water supply and drainage pipe networks has increased significantly.In the planning of urban construction,it is necessary to optimize the design of the water supply and drainage system pipe network to effectively save energy while providing residents with more accessible water resources.Therefore,the municipal water supply and drainage system and the water transmission methods should be designed according to the geographical conditions of the city.In this paper,we mainly analyze the design of municipal water supply and drainage systems and the selection of water transmission methods.Besides,the optimization of the water supply and drainage network zoning process and pipe network maintenance is also discussed,so as to provide a reference for municipal water supply and drainage work.展开更多
This article,empowered by ChatGPT and through retrieving relevant historical literature,explores how the translator Sun Yat-sen flexibly employed strategies like domestication and foreignization,as well as methods lik...This article,empowered by ChatGPT and through retrieving relevant historical literature,explores how the translator Sun Yat-sen flexibly employed strategies like domestication and foreignization,as well as methods like omission,addition,and modification in his translation of Ambulance Lectures:First Aid to the Injured.Additionally,the research highlights the use of ChatGPT as a tool to assist in the study.While ChatGPT is able to provide comprehensive knowledge quickly and proper translations,improvements are still needed in terms of image accuracy and citation generation.By providing specific context,probing for factual evidence,clarifying the reference objects,and narrowing the scope,prompts can be gradually refined for increasingly satisfactory outcomes.展开更多
Tunnel seepage is an important factor affecting the progress and safety of tunnel construction. In this paper, the mining method tunnel construction in the water-rich weathered granite stratum is taken as the research...Tunnel seepage is an important factor affecting the progress and safety of tunnel construction. In this paper, the mining method tunnel construction in the water-rich weathered granite stratum is taken as the research object. Through the analytical calculation method, the distribution law of tunnel seepage field under different waterproof and drainage types is studied, and the comparative analysis is carried out. According to the analytical solution, the influencing factors of grouting parameters are proposed. The sensitivity of the tunnel seepage field to the variation of grouting parameters is analyzed. A novel waterproof and drainage system, and construction technology suitable for subway tunnels with large buried depth below groundwater level were proposed.展开更多
Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investi...Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investigate the predictive value of the red cell distribution width(RDW)-to-albumin ratio(RAR) for the prognosis of AC. Methods: We retrospectively evaluated consecutive patients diagnosed with AC between May 2019 and March 2022. RAR was calculated, and its predictive ability for in-hospital mortality, intensive care unit(ICU) admission, bacteremia, and the length of hospitalization were analyzed. Results: Out of 438 patients, 34(7.8%) died. Multivariate analysis showed that malignant etiology [odds ratio(OR) = 4.816, 95% confidence interval(CI): 1.936-11.980], creatinine(OR = 1.649, 95% CI: 1.095-2.484), and RAR(OR = 2.064, 95% CI: 1.494-2.851) were independent risk factors for mortality. When adjusted for relevant covariates, including age, sex, malignant etiology, Tokyo severity grading(TSG), Charlson comorbidity index, and creatinine, RAR significantly predicted mortality(adjusted OR = 1.833, 95% CI: 1.280-2.624). When the cut-off of RAR was set to 3.8, its sensitivity and specificity for mortality were 94.1% and 56.7%, respectively. Patients with an RAR of > 3.8 had a 20.9-fold(OR = 20.9, 95% CI: 4.9-88.6) greater risk of mortality than the remaining patients. The area under the curve value of RAR for mortality was 0.835(95% CI: 0.770-0.901), which was significantly higher than that of TSG and the other prognostic markers, such as C-reactive protein-to-albumin ratio, and procalcitonin-to-albumin ratio. Lastly, RAR was not inferior to TSG in predicting ICU admission, bacteremia, and the length of hospitalization. Conclusions: RAR successfully predicted the in-hospital mortality, ICU admission, bacteremia, and the length of hospitalization of patients with AC, especially in-hospital mortality. RAR is a promising marker that is more convenient than TSG and other prognostic markers for predicting the prognosis of patients with AC.展开更多
Condensed and hydrolysable tannins are non-toxic natural polyphenols that are a commercial commodity industrialized for tanning hides to obtain leather and for a growing number of other industrial applications mainly ...Condensed and hydrolysable tannins are non-toxic natural polyphenols that are a commercial commodity industrialized for tanning hides to obtain leather and for a growing number of other industrial applications mainly to substitute petroleum-based products.They are a definite class of sustainable materials of the forestry industry.They have been in operation for hundreds of years to manufacture leather and now for a growing number of applications in a variety of other industries,such as wood adhesives,metal coating,pharmaceutical/medical applications and several others.This review presents the main sources,either already or potentially commercial of this forestry by-materials,their industrial and laboratory extraction systems,their systems of analysis with their advantages and drawbacks,be these methods so simple to even appear primitive but nonetheless of proven effectiveness,or very modern and instrumental.It constitutes a basic but essential summary of what is necessary to know of these sustainable materials.In doing so,the review highlights some of the main challenges that remain to be addressed to deliver the quality and economics of tannin supply necessary to fulfill the industrial production requirements for some materials-based uses.展开更多
This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional management.EUS-GBD is a minimally ...This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional management.EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery.The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate candidates.Furthermore,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture.However,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure.As the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.展开更多
BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant bili...BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.展开更多
In this study,the structural characters,antioxidant activities and bile acid-binding ability of sea buckthorn polysaccharides(HRPs)obtained by the commonly used hot water(HRP-W),pressurized hot water(HRP-H),ultrasonic...In this study,the structural characters,antioxidant activities and bile acid-binding ability of sea buckthorn polysaccharides(HRPs)obtained by the commonly used hot water(HRP-W),pressurized hot water(HRP-H),ultrasonic(HRP-U),acid(HRP-C)and alkali(HRP-A)assisted extraction methods were investigated.The results demonstrated that extraction methods had significant effects on extraction yield,monosaccharide composition,molecular weight,particle size,triple-helical structure,and surface morphology of HRPs except for the major linkage bands.Thermogravimetric analysis showed that HRP-U with filamentous reticular microstructure exhibited better thermal stability.The HRP-A with the lowest molecular weight and highest arabinose content possessed the best antioxidant activities.Moreover,the rheological analysis indicated that HRPs with higher galacturonic acid content and molecular weight showed higher viscosity and stronger crosslinking network(HRP-C,HRP-W and HRP-U),which exhibited stronger bile acid binding capacity.The present findings provide scientific evidence in the preparation technology of sea buckthorn polysaccharides with good antioxidant and bile acid binding capacity which are related to the structure affected by the extraction methods.展开更多
The role of endoscopy in pathologies of the bile duct and gallbladder has seen notable advancements over the past two decades.With advancements in stent technology,such as the development of lumen-apposing metal stent...The role of endoscopy in pathologies of the bile duct and gallbladder has seen notable advancements over the past two decades.With advancements in stent technology,such as the development of lumen-apposing metal stents,and adoption of endoscopic ultrasound and electrosurgical principles in therapeutic endoscopy,what was once considered endoscopic failure has transformed into failure of an approach that could be salvaged by a second-or third-line endoscopic strategy.Incorporation of these advancements in routine patient care will require formal training and multidisciplinary acceptance of established techniques and collaboration for advancement of experimental techniques to generate robust evidence that can be utilized to serve patients to the best of our ability.展开更多
基金supported by the National Natural Science Foundation of China(12172023).
文摘The separation-of-variable(SOV)methods,such as the improved SOV method,the variational SOV method,and the extended SOV method,have been proposed by the present authors and coworkers to obtain the closed-form analytical solutions for free vibration and eigenbuckling of rectangular plates and circular cylindrical shells.By taking the free vibration of rectangular thin plates as an example,this work presents the theoretical framework of the SOV methods in an instructive way,and the bisection–based solution procedures for a group of nonlinear eigenvalue equations.Besides,the explicit equations of nodal lines of the SOV methods are presented,and the relations of nodal line patterns and frequency orders are investigated.It is concluded that the highly accurate SOV methods have the same accuracy for all frequencies,the mode shapes about repeated frequencies can also be precisely captured,and the SOV methods do not have the problem of missing roots as well.
文摘Bcakground: Pancreatic pseudocyst (PPC) is a common complication arising from acute or chronic pancreatitis, trauma, or pancreatic duct obstruction. When acute fluid collection persists for 4 - 6 weeks and is encapsulated by a fibrous wall, it is classified as a pancreatic pseudocyst. While PPC is generally asymptomatic in many patients, it can manifest with persistent abdominal pain, dyspepsia, intra-cystic infection, and potentially lead to gastrointestinal obstruction in some cases. Although smaller PPCs may resolve spontaneously, larger PPCs tend to be refractory to absorption and often necessitate surgical intervention to prevent complications such as intracystic hemorrhage. Objective: To explore the efficacy of percutaneous catheterization with negative pressure in the treatment of large pancreatic pseudocysts. Methods: The cases of large pancreatic pseudocysts treated in our hospital from 2004 to 2022 were retrospectively collected, and the general condition, operation time, drainage time, feeding time, postoperative complications, hospital stay, cost and follow-up of the patients were analyzed. Results: A total of 132 patients with large pancreatic pseudocysts were collected. The average operation time was 32.4 ± 2.1 min;The retention time of the drainage tube was 30 ± 1.8 days in the percutaneous negative pressure drainage group;The postoperative feeding time was no fasting after local anesthesia drainage;Postoperative complications (bleeding, infection, pancreatic leakage, recurrence, anastomotic leakage, etc.): Two of the 132 patients had recurrent cysts, which were cured by re-puncture and negative pressure drainage. The length of hospital stay was 6 ± 1.1 days;The cost was 11,200 ± 1300 yuan;Follow-up: The follow-up time ranged from 1 to 3 years, and the patients had no discomfort. Conclusion: Percutaneous catheterization and negative pressure drainage can effectively treat large pancreatic pseudocysts. Compared with other treatment methods, it is simple and effective, the postoperative recovery of patients is faster, the physical damage is less, the hospital stay is shorter, and the cost is lower.
文摘Endoscopic retrograde cholangiopancreatography is considered the gold standard for treating benign and malignant biliary obstructions.However,its use in complex biliary obstructions is limited.Over the past decades,therapeutic endosonography(EUS)and emerging technologies such as lumen-apposing metal stents have enabled endoscopic treatment of conditions previously requiring nonendoscopic or surgical approaches.Studies show that EUS-guided choledochoduodenostomy is a reliable alternative to endoscopic retrograde cholangiopancreatography in the treatment of distal malignant biliary obstructions and can be considered a primary drainage modality in centers with adequate expertise.For malignant hilar biliary obstructions,draining at least 50%of viable liver tissue often requires combining different modalities.The treatment strategy in these patients should be individualized,depending on the Bismuth classification,patient physical status,and intended systemic therapy.Due to the lack of evidence,general recommendations cannot be made for EUS-guided hepaticoduodenostomy or combined procedures with transhepatic bridging stents.These novel techniques should be limited to selected palliative cases where conventional methods have failed and conducted within clinical trials to generate evidence before broader application.
文摘Objective: This study aims to investigate the drainage effect and clinical outcomes of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery, comparing the differences in postoperative pain, hospital stay, and other factors between the negative pressure group and the control group. Methods: This study is a prospective controlled trial that selected patients undergoing two-port thoracoscopic valve surgery at a certain hospital from January 2019 to December 2024. Patients were randomly assigned to the control group and the negative pressure group using a random number table method. The control group consisted of 30 patients (20 males, 10 females, mean age 42.03 ± 12.89 years), and the negative pressure group consisted of 35 patients (26 males, 9 females, mean age 41.84 ± 11.83 years). The control group received traditional chest drainage, while the negative pressure group received negative pressure chest drainage. Postoperative pain scores, hospital stay, drainage time, number of tube blockages, and incidences of pneumothorax or subcutaneous emphysema were recorded and statistically analyzed. Results: The negative pressure group had a significantly shorter postoperative drainage time compared to the control group (49.09 ± 11.99 hours vs. 79.10 ± 7.32 hours, P < 0.001). The postoperative pain score was lower in the negative pressure group (4.49 ± 1.27 vs. 7.03 ± 0.85, P < 0.001), and the hospital stay was significantly shorter (9.83 ± 1.69 days vs. 14.73 ± 2.32 days, P < 0.001). The incidence of pneumothorax or subcutaneous emphysema was significantly lower in the negative pressure group than in the control group (14.29% vs. 56.67%, P = 0.0003). Conclusion: The application of negative pressure chest drainage in patients after two-port thoracoscopic valve surgery can effectively reduce postoperative pain, shorten hospital stay, and lower the incidence of tube blockage and pneumothorax, demonstrating good clinical outcomes.
文摘Understanding the wind power potential of a site is essential for designing an optimal wind power conditioning system. The Weibull distribution and wind speed extrapolation methods are powerful mathematical tools for efficiently predicting the frequency distribution of wind speeds at a site. Hourly wind speed and direction data were collected from the National Aeronautics and Space Administration (NASA) website for the period 2013 to 2023. MATLAB software was used to calculate the distribution parameters using the graphical method and to plot the corresponding curves, while WRPLOTView software was used to construct the wind rose. The average wind speed obtained is 3.33 m/s and can reach up to 5.71 m/s at a height of 100 meters. The wind energy is estimated to be 1315.30 kWh/m2 at a height of 100 meters. The wind rose indicates the prevailing winds (ranging from 3.60 m/s to 5.70 m/s) in the northeast-east direction.
基金supported by the Innovation Foundation of Provincial Education Department of Gansu(2024B-005)the Gansu Province National Science Foundation(22YF7GA182)the Fundamental Research Funds for the Central Universities(No.lzujbky2022-kb01)。
文摘Modal parameters can accurately characterize the structural dynamic properties and assess the physical state of the structure.Therefore,it is particularly significant to identify the structural modal parameters according to the monitoring data information in the structural health monitoring(SHM)system,so as to provide a scientific basis for structural damage identification and dynamic model modification.In view of this,this paper reviews methods for identifying structural modal parameters under environmental excitation and briefly describes how to identify structural damages based on the derived modal parameters.The paper primarily introduces data-driven modal parameter recognition methods(e.g.,time-domain,frequency-domain,and time-frequency-domain methods,etc.),briefly describes damage identification methods based on the variations of modal parameters(e.g.,natural frequency,modal shapes,and curvature modal shapes,etc.)and modal validation methods(e.g.,Stability Diagram and Modal Assurance Criterion,etc.).The current status of the application of artificial intelligence(AI)methods in the direction of modal parameter recognition and damage identification is further discussed.Based on the pre-vious analysis,the main development trends of structural modal parameter recognition and damage identification methods are given to provide scientific references for the optimized design and functional upgrading of SHM systems.
基金supported by grants from the Shandong Provincial Natural Science Foundation(No.ZR2021MH033)the Linyi People’s Hospital,and the Key R&D Plan of Linyi City(No.2023xy0029).
文摘Objective Laparoscopic surgery has become a routine general surgery with many advantages,such as alleviating abdominal pain.However,postoperative pain caused by abdominal drainage tubes has attracted little attention from medical staff.The aim of this study was to explore the influence of a new abdominal drainage tube fixation method for 3-port laparoscopic cholecystectomy(LC)on patients’postoperative quality of life.Methods Patients who underwent 3-port LC with abdominal drainage tubes in the Department of Hepatobiliary Surgery of Linyi People’s Hospital from March 1,2023 to October 31,2023 due to gallstones with chronic cholecystitis were selected for this study.The patients were randomly divided into an experimental group and a control group.In the experimental group,the new abdominal drainage tube fixation method was used,while in the control group,the traditional method was used.Afterward,the quality of life of patient in terms of pain,activity,recovery time,and mental health status was evaluated.The exudate around the patient’s drainage tube was collected for bacterial culture and analysis.Results A total of 139 patients were randomly divided into an experimental group(70 patients)and a control group(69 patients).The patients’baseline characteristics were not significantly different.The patients in the experimental group had better outcomes in quality of life,with higher pain scores(24.03±2.37 vs.15.48±2.29,p<0.001)and activity scores(20.57±1.78 vs.14.13±1.43,p<0.001),and a shorter postoperative recovery time(2.36±0.68 d vs.2.96±1.34 d,p<0.001).The same results were shown in linear regression analysis scores of the 2 groups.The positive rate of bacterial culture in the exudate around the patient’s drainage tube in the experimental group was significantly lower than that in the control group(12.9%vs.43.5%,p<0.001);and furthermore,the positive rate of conditional pathogenic bacteria was even lower(7.1%vs.33.3%,p<0.001)in the experimental group than in the control group.Conclusion This new abdominal drainage tube fixation method can effectively promote patient rehabilitation and improve the quality of life for patient following 3-port LC with abdominal drainage tubes.
文摘Drainage divide migration refers to the shifting boundaries between adjacent drainage basins over time,driven by processes such as tectonic uplift,differential erosion,stream capture,and lithological variations.This phenomenon has a significant impact on water flow patterns and basin extents,serving as an indicator of the landscape's response to active tectonic forces.One of the key drivers of divide migration is asymmetric uplift,which causes divides to shift from areas of lower uplift to regions experiencing higher uplift.Drainage divides are inherently dynamic,evolving over time as drainage networks develop and adjust to changing conditions.This study focuses on the migration of the main drainage divide along Karιncalιda?,located between Bozdo?an and Karacasu.It employs geomorphic analyses using metrics such as the normalized steepness index(ksn),Chi(χ),and Gilbert metrics.The main divide is categorized into four segments(D1–D4),with the Karacasu Fault,situated along the mountain's north-eastern boundary,identified as the primary factor influencing divide dynamics.Secondary factors include the relatively low elevation of Karιncalιda?,uniform lithology,and consistent rainfall patterns across the region.The results indicate that the main divide is currently stable,suggesting a balance between uplift and erosion.However,higherχvalues in the D4 segment suggest that future erosion may dominate,potentially causing the divide to migrate toward the Bozdo?an Basin.These findings highlight the dynamic nature of drainage divides and the complex interplay of tectonic,erosional,and lithological processes that shape their evolution.Continued monitoring and advanced geomorphic analysis are essential for understanding the long-term stability of the divide and its response to future tectonic activity and erosional modifications.
基金funded by the Basic Scientific Fund for National Public Research Institutes of China(No.2022 S01)the National Natural Science Foundation of China(Nos.42176191,42049902,and U22A2012)+5 种基金the Shandong Provincial Natural Science Foundation,China(No.ZR2022YQ40)the National Key R&D Program of China(No.2021YFF0501202)the Southern Marine Science and Engineering Guangdong Laboratory(Zhuhai)(No.SML2023 SP232)the Fundamental Research Funds for the Central Universities,Sun Yat-sen University(No.241gqb006)Data acquisition and sample collections were supported by the National Natural Science Foundation of China Open Research Cruise(Cruise No.NORC2021-02+NORC2021301)funded by the Shiptime Sharing Project of the National Natural Science Foundation of China。
文摘Accurate acquisition and prediction of acoustic parameters of seabed sediments are crucial in marine sound propagation research.While the relationship between sound velocity and physical properties of sediment has been extensively studied,there is still no consensus on the correlation between acoustic attenuation coefficient and sediment physical properties.Predicting the acoustic attenuation coefficient remains a challenging issue in sedimentary acoustic research.In this study,we propose a prediction method for the acoustic attenuation coefficient using machine learning algorithms,specifically the random forest(RF),support vector machine(SVR),and convolutional neural network(CNN)algorithms.We utilized the acoustic attenuation coefficient and sediment particle size data from 52 stations as training parameters,with the particle size parameters as the input feature matrix,and measured acoustic attenuation as the training label to validate the attenuation prediction model.Our results indicate that the error of the attenuation prediction model is small.Among the three models,the RF model exhibited the lowest prediction error,with a mean squared error of 0.8232,mean absolute error of 0.6613,and root mean squared error of 0.9073.Additionally,when we applied the models to predict the data collected at different times in the same region,we found that the models developed in this study also demonstrated a certain level of reliability in real prediction scenarios.Our approach demonstrates that constructing a sediment acoustic characteristics model based on machine learning is feasible to a certain extent and offers a novel perspective for studying sediment acoustic properties.
文摘BACKGROUND Gastric ulcer perforation is a critical condition that can lead to significant morbidity and mortality if not promptly addressed.It is often the result of chronic peptic ulcer disease,which is characterized by a breach in the gastric wall due to ulceration.Surgical intervention is essential for managing this life-threatening complication.However,the optimal surgical technique remains debatable among clinicians.Various methods have been employed,including simple closure,omental patch repair,and partial gastrectomy,each with distinct advantages and disadvantages.Understanding the comparative efficacy and postoperative outcomes of these techniques is crucial for improving patient care and surgical decision-making.This study addresses the need for a comprehensive analysis in this area.AIM To compare the efficacy and postoperative complications of different surgical methods for the treatment of gastric ulcer perforation.METHODS A retrospective analysis was conducted on 120 patients who underwent surgery for gastric ulcer perforation between September 2020 and June 2023.The patients were divided into three groups based on the surgical method:Simple closure,omental patch repair,and partial gastrectomy.The primary outcomes were the operative success rate and incidence of postoperative complications.Secondary outcomes included the length of hospital stay,recovery time,and long-term quality of life.RESULTS The operative success rates for simple closure,omental patch repair,and partial gastrectomy were 92.5%,95%,and 97.5%,respectively.Postoperative complications occurred in 20%,15%,and 17.5%of patients in each group,respectively.The partial gastrectomy group showed a significantly longer operative time(P<0.001)but the lowest rate of ulcer recurrence(2.5%,P<0.05).The omental patch repair group demonstrated the shortest hospital stay(mean 7.2 days,P<0.05)and fastest recovery time.CONCLUSION While all three surgical methods showed high success rates,omental patch repair demonstrated the best overall outcomes,with a balance of high efficacy,low complication rates,and shorter recovery time.However,the choice of the surgical method should be tailored to individual patient factors and the surgeon’s expertise.
基金supported by the National Natural Science Foundation of China(82274675&82074573)the Beijing Natural Science Foundation(7232278).
文摘Objective:To investigate the effects of“Three Methods and Three Acupoints”(TMTP)Tuina therapy on spinal microcirculation in sciatic nerve injury(SNI).Methods:Thirty-six SpragueeDawley rats were randomly assigned to four groups:normal,sham operation,model,and TMTP Tuina.Successful model induction was confirmed by observable hind limb lameness.After 20 sessions,hind limb grip strength and motor nerve conduction velocity(MNCV)were measured at baseline and following the 10th and 20th intervention.CD31 and a-SMA in the ventral horn of SNI model rats were detected using immunofluorescence.Motor neurons in the ventral horn were detected by Nissl staining.PTEN levels in the ventral horn were measured by ELISA,and PI3K,Akt,BDNF,VEGF,and HIF-1a expression was determined by RT-PCR.Spinal cord microcirculation was evaluated by western blotting analysis of the levels of Akt,p-Akt,BDNF,and VEGF.Results:Hind limb grip strength and MNCV significantly improved in the TMTP Tuina group compared to the model group(both P<.001).Morphology of ventral horn motor neurons in the TMTP Tuina group improved compared to the model group,with increased expressions of a-SMA(P=.002)and CD31(P=.006).Western blot analysis indicated increased expression of VEGF(P=.005),p-Akt(P<.001),and BDNF(P=.008)in the ventral horn following Tuina treatment.RT-PCR analysis revealed increased expression of PI3K,Akt,BDNF,VEGF and HIF-1a(all P<.05).In contrast,expression of PTEN decreased compared to the model group(P<.001).Conclusion:TMTP Tuina therapy may restore motor function in rats,enhance ventral horn motor neuron morphology,and promote angiogenesis and vascular smooth muscle proliferation.The mechanism may involve the activation of the PI3K/Akt signaling pathway.
文摘With the acceleration of urbanization,the demand for water supply and drainage pipe networks has increased significantly.In the planning of urban construction,it is necessary to optimize the design of the water supply and drainage system pipe network to effectively save energy while providing residents with more accessible water resources.Therefore,the municipal water supply and drainage system and the water transmission methods should be designed according to the geographical conditions of the city.In this paper,we mainly analyze the design of municipal water supply and drainage systems and the selection of water transmission methods.Besides,the optimization of the water supply and drainage network zoning process and pipe network maintenance is also discussed,so as to provide a reference for municipal water supply and drainage work.
基金Research on AI Empowered Bilingual Language Asset Management and English Language Teaching Reform(24JG29)Research on the Digital Empowerment in Business English Major Reform and Innovation in the Context of Language Services(National Higher Education Institutions 202412583HN)Chinese Academic Translation Project of“C-E Translation of The Transformation of Rural China”(21WSHB004)。
文摘This article,empowered by ChatGPT and through retrieving relevant historical literature,explores how the translator Sun Yat-sen flexibly employed strategies like domestication and foreignization,as well as methods like omission,addition,and modification in his translation of Ambulance Lectures:First Aid to the Injured.Additionally,the research highlights the use of ChatGPT as a tool to assist in the study.While ChatGPT is able to provide comprehensive knowledge quickly and proper translations,improvements are still needed in terms of image accuracy and citation generation.By providing specific context,probing for factual evidence,clarifying the reference objects,and narrowing the scope,prompts can be gradually refined for increasingly satisfactory outcomes.
文摘Tunnel seepage is an important factor affecting the progress and safety of tunnel construction. In this paper, the mining method tunnel construction in the water-rich weathered granite stratum is taken as the research object. Through the analytical calculation method, the distribution law of tunnel seepage field under different waterproof and drainage types is studied, and the comparative analysis is carried out. According to the analytical solution, the influencing factors of grouting parameters are proposed. The sensitivity of the tunnel seepage field to the variation of grouting parameters is analyzed. A novel waterproof and drainage system, and construction technology suitable for subway tunnels with large buried depth below groundwater level were proposed.
文摘Background: It is crucial to assess the severity of acute cholangitis(AC). There are currently several prognostic markers. However, the accuracies of these markers are not satisfied. The present study aimed to investigate the predictive value of the red cell distribution width(RDW)-to-albumin ratio(RAR) for the prognosis of AC. Methods: We retrospectively evaluated consecutive patients diagnosed with AC between May 2019 and March 2022. RAR was calculated, and its predictive ability for in-hospital mortality, intensive care unit(ICU) admission, bacteremia, and the length of hospitalization were analyzed. Results: Out of 438 patients, 34(7.8%) died. Multivariate analysis showed that malignant etiology [odds ratio(OR) = 4.816, 95% confidence interval(CI): 1.936-11.980], creatinine(OR = 1.649, 95% CI: 1.095-2.484), and RAR(OR = 2.064, 95% CI: 1.494-2.851) were independent risk factors for mortality. When adjusted for relevant covariates, including age, sex, malignant etiology, Tokyo severity grading(TSG), Charlson comorbidity index, and creatinine, RAR significantly predicted mortality(adjusted OR = 1.833, 95% CI: 1.280-2.624). When the cut-off of RAR was set to 3.8, its sensitivity and specificity for mortality were 94.1% and 56.7%, respectively. Patients with an RAR of > 3.8 had a 20.9-fold(OR = 20.9, 95% CI: 4.9-88.6) greater risk of mortality than the remaining patients. The area under the curve value of RAR for mortality was 0.835(95% CI: 0.770-0.901), which was significantly higher than that of TSG and the other prognostic markers, such as C-reactive protein-to-albumin ratio, and procalcitonin-to-albumin ratio. Lastly, RAR was not inferior to TSG in predicting ICU admission, bacteremia, and the length of hospitalization. Conclusions: RAR successfully predicted the in-hospital mortality, ICU admission, bacteremia, and the length of hospitalization of patients with AC, especially in-hospital mortality. RAR is a promising marker that is more convenient than TSG and other prognostic markers for predicting the prognosis of patients with AC.
文摘Condensed and hydrolysable tannins are non-toxic natural polyphenols that are a commercial commodity industrialized for tanning hides to obtain leather and for a growing number of other industrial applications mainly to substitute petroleum-based products.They are a definite class of sustainable materials of the forestry industry.They have been in operation for hundreds of years to manufacture leather and now for a growing number of applications in a variety of other industries,such as wood adhesives,metal coating,pharmaceutical/medical applications and several others.This review presents the main sources,either already or potentially commercial of this forestry by-materials,their industrial and laboratory extraction systems,their systems of analysis with their advantages and drawbacks,be these methods so simple to even appear primitive but nonetheless of proven effectiveness,or very modern and instrumental.It constitutes a basic but essential summary of what is necessary to know of these sustainable materials.In doing so,the review highlights some of the main challenges that remain to be addressed to deliver the quality and economics of tannin supply necessary to fulfill the industrial production requirements for some materials-based uses.
文摘This narrative review provides an overview of the utilization of endoscopic ultrasound-guided gallbladder drainage(EUS-GBD)as a salvage approach in cases of unsuccessful conventional management.EUS-GBD is a minimally invasive and effective technique for drainage in patients with acute cholecystitis with high risk of surgery.The procedure has demonstrated impressive technical and clinical success rates with low rates of adverse events,making it a safe and effective option for appropriate candidates.Furthermore,EUS-GBD can also serve as a rescue option for patients who have failed endoscopic retrograde cholangiopancreatography or EUS biliary drainage for relief of jaundice in malignant biliary stricture.However,patient selection is critical for the success of EUS-GBD,and proper patient selection and risk assessment are important to ensure the safety and efficacy of the procedure.As the field continues to evolve and mature,ongoing research will further refine our understanding of the benefits and limitations of EUS-GBD,ultimately leading to improved outcomes for patients.
基金The authors have read the PRISMA 2009 Checklist,and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
文摘BACKGROUND Endoscopic ultrasound-guided biliary drainage using electrocautery-enhanced(ECE)delivery of lumen-apposing metal stent(LAMS)is gradually being re-cognized as a viable palliative technique for malignant biliary obstruction after endoscopic retrograde cholangiopancreatography(ERCP)failure.However,most of the studies that have assessed its efficacy and safety were small and hetero-geneous.Prior meta-analyses of six or fewer studies that were published 2 years ago were therefore underpowered to yield convincing evidence.AIM To update the efficacy and safety of ECE-LAMS for treatment of biliary ob-struction after ERCP failure.METHODS We searched PubMed,EMBASE,and Scopus databases from the inception of the ECE technique to May 13,2022.Primary outcome measure was pooled technical success rate,and secondary outcomes were pooled rates of clinical success,re-intervention,and adverse events.Meta-analysis was performed using a random-effects model following Freeman-Tukey double-arcsine transformation in R soft-ware(version 4.1.3).RESULTS Fourteen eligible studies involving 620 participants were ultimately included.The pooled rate of technical success was 96.7%,and clinical success was 91.0%.Adverse events were reported in 17.5%of patients.Overall reinter-vention rate was 7.3%.Subgroup analyses showed results were generally consistent.CONCLUSION ECE-LAMS has favorable success with acceptable adverse events in relieving biliary obstruction when ERCP is impossible.The consistency of results across most subgroups suggested that this is a generalizable approach.
基金The Guangdong Basic and Applied Basic Research Foundation(2022A1515010730)National Natural Science Foundation of China(32001647)+2 种基金National Natural Science Foundation of China(31972022)Financial and moral assistance supported by the Guangdong Basic and Applied Basic Research Foundation(2019A1515011996)111 Project(B17018)。
文摘In this study,the structural characters,antioxidant activities and bile acid-binding ability of sea buckthorn polysaccharides(HRPs)obtained by the commonly used hot water(HRP-W),pressurized hot water(HRP-H),ultrasonic(HRP-U),acid(HRP-C)and alkali(HRP-A)assisted extraction methods were investigated.The results demonstrated that extraction methods had significant effects on extraction yield,monosaccharide composition,molecular weight,particle size,triple-helical structure,and surface morphology of HRPs except for the major linkage bands.Thermogravimetric analysis showed that HRP-U with filamentous reticular microstructure exhibited better thermal stability.The HRP-A with the lowest molecular weight and highest arabinose content possessed the best antioxidant activities.Moreover,the rheological analysis indicated that HRPs with higher galacturonic acid content and molecular weight showed higher viscosity and stronger crosslinking network(HRP-C,HRP-W and HRP-U),which exhibited stronger bile acid binding capacity.The present findings provide scientific evidence in the preparation technology of sea buckthorn polysaccharides with good antioxidant and bile acid binding capacity which are related to the structure affected by the extraction methods.
文摘The role of endoscopy in pathologies of the bile duct and gallbladder has seen notable advancements over the past two decades.With advancements in stent technology,such as the development of lumen-apposing metal stents,and adoption of endoscopic ultrasound and electrosurgical principles in therapeutic endoscopy,what was once considered endoscopic failure has transformed into failure of an approach that could be salvaged by a second-or third-line endoscopic strategy.Incorporation of these advancements in routine patient care will require formal training and multidisciplinary acceptance of established techniques and collaboration for advancement of experimental techniques to generate robust evidence that can be utilized to serve patients to the best of our ability.
